<!DOCTYPE html>
<html xmlns="http://www.w3.org/1999/xhtml">
<head>
    <meta http-equiv="Content-Type" content="text/html; charset=utf-8"/>
    <title>修改充值记录表</title>
    <link type="text/css" rel="stylesheet" href="../css/common/base-min.css" media="all"/>
    <link type="text/css" rel="stylesheet" href="../css/common/index.css" media="all"/>
    <script type="text/javascript" src="../js/jquery/jquery-1.8.3.min.js?ts=new Date()"></script>
    <script type="text/javascript" src="../js/jquery/jquery-form.js?ts=new Date()"></script>
    <script type="text/javascript" src="../js/layer/layer.js?ts=new Date()"></script>
    <script type="text/javascript" src="../../common.js"></script>
    <script type="text/javascript" src="../js/common/common.js?ts=new Date()"></script>
    <script type="text/javascript" src="../js/record/corerechargerecord_modify.js?ts=new Date()"></script>
</head>

<body>
<div class="box">
    <ul class="list">
        <li class="list-li">
            <label class="leftLi">充值用户：</label>
            <div class="rightLi">
                <input type="text" class="inputStyle crrerUser"/>
                <span class="p-red"> *</span>
            </div>
        </li>
        <li class="list-li">
            <label class="leftLi">充值状态:1成功,0失败,2申请充值：</label>
            <div class="rightLi">
                <input type="text" class="inputStyle crrerStatus"/>
                <span class="p-red"> *</span>
            </div>
        </li>
        <li class="list-li">
            <label class="leftLi">充值金额：</label>
            <div class="rightLi">
                <input type="text" class="inputStyle crrerFee"/>
                <span class="p-red"> *</span>
            </div>
        </li>
        <li class="list-li">
            <label class="leftLi">充值时间：</label>
            <div class="rightLi">
                <input type="text" class="inputStyle crrerDate"/>
                <span class="p-red"> *</span>
            </div>
        </li>
        <li class="list-li">
            <label class="leftLi">所属油卡：</label>
            <div class="rightLi">
                <input type="text" class="inputStyle crrerOil"/>
                <span class="p-red"> *</span>
            </div>
        </li>
        <li class="list-li">
            <label class="leftLi">是否带发票（1是，2否）：</label>
            <div class="rightLi">
                <input type="text" class="inputStyle crrerInvoice"/>
                <span class="p-red"> *</span>
            </div>
        </li>
        <li class="list-li">
            <label class="leftLi">使用的优惠券合集：</label>
            <div class="rightLi">
                <input type="text" class="inputStyle crrerUseCoupon"/>
                <span class="p-red"> *</span>
            </div>
        </li>
        <li class="list-li">
            <label class="leftLi">可获得的优惠券：</label>
            <div class="rightLi">
                <input type="text" class="inputStyle crrerGetCoupon"/>
                <span class="p-red"> *</span>
            </div>
        </li>
        <li class="list-li">
            <label class="leftLi">支付方式（1微信支付，2银联支付）：</label>
            <div class="rightLi">
                <input type="text" class="inputStyle crrerPayType"/>
                <span class="p-red"> *</span>
            </div>
        </li>
        <li class="list-li">
            <label class="leftLi">交易单号：</label>
            <div class="rightLi">
                <input type="text" class="inputStyle crrerOrder"/>
                <span class="p-red"> *</span>
            </div>
        </li>
        <li class="list-li">
            <label class="leftLi">代理商平台(1本平台)：</label>
            <div class="rightLi">
                <input type="text" class="inputStyle crrerAgent"/>
                <span class="p-red"> *</span>
            </div>
        </li>
        <li class="list-li">
            <label class="leftLi">代理商回调url：</label>
            <div class="rightLi">
                <input type="text" class="inputStyle crrerCallbackUrl"/>
                <span class="p-red"> *</span>
            </div>
        </li>
        <li class="list-li">
            <input type="button" class="buttonStyle submit" value="修改"/>
        </li>
    </ul>
</div>
</body>
</html>
